{"id":8822,"date":"2024-08-05T13:43:58","date_gmt":"2024-08-05T13:43:58","guid":{"rendered":"https:\/\/ambercell.eu\/?p=8822"},"modified":"2024-08-05T14:01:20","modified_gmt":"2024-08-05T14:01:20","slug":"transarteriline-kemoemboolia-tace-tohus-vahend-maksavahi-vastases-voitluses","status":"publish","type":"post","link":"https:\/\/ambercell.eu\/et\/uudised\/transarteriline-kemoemboolia-tace-tohus-vahend-maksavahi-vastases-voitluses\/","title":{"rendered":"Uriinipidamatus ei m\u00f6\u00f6du ka noortest: ilma ravita on aeg kadunud"},"content":{"rendered":"\n

Maailma Terviseorganisatsioon (WHO) deklareerib, et erinevates riikides puutub 10-30% inimestest kokku uriinipidamatusega (uriinipidamatus).\nPatsientidel.\nLeedus puudub ametlik statistika uriinipidamatuse esinemissageduse kohta, kuid arstide s\u00f5nul puutuvad nad igap\u00e4evaselt kokku patsientidega, keda see probleem h\u00e4irib.\nHea uudis on see, et uriinipidamatuse juhtumeid \u2013 isegi kaugelearenenud staadiumis \u2013 saab ohjeldada. <\/p>\n\n

Uriinipidamatus halvendab inimeste elukvaliteeti<\/strong><\/p>\n\n

VUL Santarose kliiniku<\/a> uroloogi Aivaras Grybase s\u00f5nul m\u00f5jub uriinipidamatus inimese elule t\u00e4iesti negatiivselt \u2013 see h\u00e4irib f\u00fc\u00fcsilist aktiivsust, t\u00f6\u00f6v\u00f5imet, v\u00f5imalusi reisida, sportida, \u00fcritustel osaleda.\nNaised, kes seisavad p\u00e4rast s\u00fcnnitust silmitsi uriinipidamatusega, kogevad sageli ebamugavust ka intiimelu valdkonnas.\nUriinipidamatus m\u00f5jutab mehi ka emotsionaalselt ja f\u00fcsioloogiliselt \u2013 pole haruldane, et nad keelduvad t\u00e4ie\u00f5iguslikust seksuaalvahekorrast. <\/p>\n\n

Negatiivselt m\u00f5jutab see probleem mitte ainult inimest ennast, vaid ka tema k\u00f5rval olevat partnerit, kes peab ka teatud tegevustest loobuma.<\/p>\n\n

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“Mul oli patsient, kes \u00fctles mulle, et uriinipidamatuse ja ebameeldiva l\u00f5hna t\u00f5ttu ei tule lapselapsed tema juurde koju.\nKui valus see on ja inimesele oluline.\nP\u00e4rast sellise probleemi lahendamist taastub enesekindlus ja paraneb elukvaliteet,” \u00fctleb uroloog. <\/p>\n<\/div><\/div>\n\n

<\/div>\n\n

Uriinipidamatuse p\u00f5hjused<\/strong><\/p>\n\n

Uroloog ja VUL Santarose kliiniku<\/a> dotsent Au\u0161ra \u010cerniauskien\u0117 m\u00e4rgib, et uriinipidamatus h\u00e4irib naisi kolm korda sagedamini, kuid auv\u00e4\u00e4rsesse ikka j\u00f5udnud inimesed kannatavad sama sageli.<\/p>\n\n

Kuigi selle vaevuse p\u00f5hjused v\u00f5ivad olla erinevad, p\u00f5hjustab noortel ja keskealistel inimestel uriinipidamatust k\u00f5ige sagedamini alumiste kuseteede anatoomilised muutused v\u00f5i p\u00f5ie, kusiti voldi aktiivsuse halvenemine.\nEakatel v\u00f5ib seda h\u00e4iret p\u00f5hjustada kroonilised haigused (n\u00e4iteks rasvumine, suhkurt\u00f5bi), ravimite liigne kasutamine, funktsionaalse v\u00f5imekuse v\u00e4henemine.\nM\u00e4rgitakse ka muid tegureid, mis v\u00f5ivad p\u00f5hjustada uriinipidamatust: v\u00e4henenud liikuvus, hormonaalsed muutused, selja- ja peavigastused, kiiritusravi, s\u00fcdamepuudulikkus, k\u00f5hukinnisus, fekaalipidamatus ja muud p\u00f5hjused.\nEnamasti on need keerulised. <\/p>\n\n

\n

A. \u010cerniauskien\u0117 s\u00f5nul esineb meestel uriinipidamatus k\u00f5ige sagedamini p\u00e4rast eesn\u00e4\u00e4rme eemaldamise operatsioone ja naistel kasvab uriinipidamatuse risk koos loomulike s\u00fcnnituste arvuga, eriti keeruliste v\u00f5i suurte lootes\u00fcnnituste korral.\nSamuti suureneb risk p\u00e4rast erinevaid g\u00fcnekoloogilisi haigusi, n\u00e4iteks vaagnaelundite laskumise ilmnemise, vaagnap\u00f5hja lihaste n\u00f5rgenemise t\u00f5ttu. <\/p>\n<\/div>

\"\"<\/figure><\/div>\n\n

Kui te ei l\u00e4he arstide juurde, on aeg kadunud<\/strong><\/p>\n\n

Uroloog ja Kaunase kliiniku dotsent Darius Trumbeckas \u00fctleb, et naised puutuvad uriinipidamatusega enamasti kokku juba p\u00e4rast menopausi.\nKuid D. Trumbecki s\u00f5nul on ka nooremaid, umbes 35-40-aastaseid patsiente, keda see ebameeldiv haigus h\u00e4irib. <\/p>\n\n

Uroloog rahustab neid, kes kardavad, et arstide juurde on hilja minna, kuid soovitab tungivalt mitte viivitada ravi l\u00e4bimise otsusega: “Uriinipidamatus ei ole onkoloogiline haigus.\nIsik ei hiline arsti juurde, kuid ta kaotab aega.\nKui uriinipidamatus on m\u00e4rkimisv\u00e4\u00e4rne, kui te ei saa seda f\u00fcsioteraapia v\u00f5i ravimitega ravida, pole midagi oodata. <\/p>\n\n

<\/div>\n\n
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D. Trumbeckas m\u00e4rgib, et mehed, keda opereeritakse eesn\u00e4\u00e4rmev\u00e4hi korral, p\u00f6\u00f6rduvad uriinipidamatuse korral uriinipidamatuse poole tavaliselt 50-70-aastaselt, kuid m\u00f5nikord saabuvad ka 80-aastased \u2013 tavaliselt on nad uriinipidamatusega leppinud 5 v\u00f5i isegi 10 aastat.<\/p>\n<\/div><\/div>\n\n

<\/div>\n\n

Uroloog A. Grybas sekundeerib, et vanemad inimesed viivitavad sageli probleemiga, uskudes, et uriinipidamatus on vanaduse tagaj\u00e4rg.\nUriini l\u00f5hn majas v\u00f5ib l\u00e4hedastele m\u00e4rku anda, et inimesele tuleks abi pakkuda. <\/p>\n\n

“Ma soovitan teil julgustada oma vanemaid arstide juurde minema.\nAlati on v\u00f5imalik neid v\u00e4hemalt teavitada v\u00f5imalikest h\u00fcgieeni- ja ravimeetmetest,” soovitab A. Grybas. <\/p>\n\n

Tema s\u00f5nul pakub riik t\u00e4nap\u00e4eval Leedu patsientidele tuge uriinipidamatuse probleemi lahendamisel.\nKompenseerib nii padjad kui ka m\u00e4hkmed, samuti kirurgilised ja mittekirurgilised ravivahendid. <\/p>\n\n

A. Grybase s\u00f5nul v\u00f5ib uriinipidamatust eristada kolme t\u00fc\u00fcpi: pinge, kiireloomulisus ja segatud uriinipidamatus.\nSamuti jaguneb uriinipidamatus kergeks, keskmiseks ja k\u00f5rgeks kraadiks. <\/p>\n\n

“Kuigi kraadi on raske t\u00e4pselt kindlaks m\u00e4\u00e4rata, t\u00e4heldatakse oodatavaid n\u00e4itajaid: kui p\u00e4evas kaob v\u00e4hem kui 200 ml uriini, on see kerge uriinipidamatuse aste.\nKui 200-400 ml \u2013 keskmine, kui \u00fcle 400 ml \u2013 k\u00f5rge tase,” selgitab arst. <\/p>\n\n

Samuti k\u00fcsivad arstid patsientidelt, kui palju padjaid nad p\u00e4evas tarbivad.\nKui on vaja 3-4 padjandit, on t\u00f5en\u00e4oline, et inimesel on m\u00f5\u00f5dukas uriinipidamatuse aste, kui see on suurem kui 4 – k\u00f5rge.\nLoomulikult s\u00f5ltub tarbitud patjade kogus ka patjade t\u00fc\u00fcbist, patsiendi h\u00fcgieeniharjumustest. <\/p>\n\n

Minimaalselt invasiivsed ravimeetodid \u2013 \u00e4\u00e4rmiselt t\u00f5husad<\/strong><\/p>\n\n

A. Grybase s\u00f5nul jaguneb uriinipidamatuse ravi sekkuvateks ja mittesekkuvateks (v\u00f5i konservatiivseteks) ravimeetoditeks.\nKonservatiivsed ravimeetodid h\u00f5lmavad ravimeid, f\u00fcsioterapeutilisi meetmeid, sekkuvat (v\u00f5i minimaalselt invasiivset) – subscapular sideme v\u00f5i kunstliku sulgurlihase implanteerimist. <\/p>\n\n

A. \u010cerniauskien\u0117 s\u00f5nul hakati kerge ja m\u00f5\u00f5duka uriinipidamatuse astmega patsientidel alates 2008. aastast implanteerima subscapular sidemete implanteerimist Santara kliinikute uroloogiakeskusesse, raske kusepidamatuse korral \u2013 p\u00f5ie kunstlik sulgurlihas.\nAlates 2014. aastast on kasutusele v\u00f5etud uuenduslik ravimeetod, mis asendab p\u00f5ie sulgurlihase uue ATOMS-s\u00fcsteemiga.\nKirjanduse andmetel teatatakse p\u00e4rast uusi implantatsioone headest tulemustest kuni 84,2-92 protsenti.\nJuhtudel. <\/p>\n\n

D. Trumbeckas lisab, et Kaunase kliinikutes <\/a> ravitakse uriinipidamatuse all kannatavaid patsiente samade meetoditega \u2013 implanteerides sublapsaalseid sidemeid, ATOMS-s\u00fcsteeme v\u00f5i kunstlikke sfinktereid.<\/p>\n\n

Alates 2018. aastast on need kallid uriinipidamatuse ravivahendid kantud tsentraalselt ostetud meditsiiniseadmete nimekirja.\nSee t\u00e4hendab, et neid meditsiinilisi abivahendeid ostab tsentraalselt riiklik haigekassa tervishoiuministeeriumi (VLK) alluvuses ja need h\u00fcvitatakse kohustusliku haigekassa eelarvest.\nSel viisil tarnitakse VLK ostetud vahendid meditsiiniasutustesse, kes rakendavad neid ravimeetodeid, ja on tasuta k\u00e4ttesaadavad k\u00f5igile uriinipidamatuse all kannatavatele patsientidele. <\/p>\n\n

A. Grybase s\u00f5nul on ravi efektiivne ja pole palju vastun\u00e4idustusi, mis n\u00f5uaksid nendest minimaalselt invasiivsetest kirurgilistest ravimeetoditest loobumist: neid ei tehta tavaliselt juhtudel, kui sellised kaasnevad haigused nagu h\u00fc\u00fcbimish\u00e4ired, m\u00e4rkimisv\u00e4\u00e4rne s\u00fcdamepuudulikkus, k\u00f5rgeima astme rasvumine on \u00fclekaalus.<\/p>\n\n

“Kuid iga juhtum on individuaalne, see otsustatakse koos patsiendiga, n\u00e4iteks enne operatsiooni tehakse talle kardioloogiline, dieet- v\u00f5i muu ettevalmistus.\nMuidugi tekitavad patsiendid, kes seisavad p\u00e4rast eesn\u00e4\u00e4rmev\u00e4hi kiiritusravi silmitsi kusiti armistumise probleemiga, rohkem v\u00e4ljakutseid, kuid neid saab ka aidata, “\u00fctleb meedik. <\/p>\n\n

Ta r\u00f5hutab, et uriinipidamatusega patsiendid peaksid k\u00f5igepealt minema perearsti juurde ja p\u00e4rast saatekirja saamist tulema uroloogi juurde konsultatsioonile – seej\u00e4rel valitakse p\u00e4rast vajalike testide tegemist k\u00f5ige sobivam ravi.<\/p>\n\n

Ravitulemused \u00fcletavad sageli patsientide ootusi<\/strong><\/p>\n\n

A. Grybase s\u00f5nul on palju patsiente, kes on rahul kirurgilise ravi heade tulemustega.\nPaljud neist olid veendunud, et uriinipidamatuse p\u00f5hjustatud muutused olid p\u00f6\u00f6rdumatud. <\/p>\n\n

“Meil on palju tunnistusi patsientidelt, kes p\u00e4rast 10 v\u00f5i enam aastat selliseid operatsioone naudivad elukvaliteedi olulist paranemist,” m\u00e4rgib ta.<\/p>\n\n

Uroloog D. Trumbeck n\u00f5ustub, et implantaadid v\u00f5ivad oluliselt v\u00e4hendada meeste ja naiste uriinipidamatust.\nTema s\u00f5nul on vaid \u00fche padja kasutamine p\u00e4evas p\u00e4rast sekkumist hea ravi tulemus, kuna absoluutne kuivus on looduse, mitte inimese loodud asi. <\/p>\n\n

Samal ajal m\u00e4letab A. \u010cerniauskien\u0117 lugu, kui 62-aastasel mehel diagnoositi 2018. aastal eesn\u00e4\u00e4rme kartsinoom ja talle tehti radikaalne operatsioon eesn\u00e4\u00e4rme eemaldamiseks.\nP\u00e4rast operatsiooni tekkis patsiendil f\u00fc\u00fcsilise koormuse ajal uriinipidamatus, ta tarbis 3-4 padja p\u00e4evas. <\/p>\n\n

Mehele m\u00e4\u00e4rati konservatiivne ravi, mis, kui see pole \u00f5igustatud, patsiendile 2020. aastal.\nimplanteeriti reguleeritav sub-wet side.\nSoovitud tulemuste puudumisel 2023. aastal.\npatsient implanteeriti ATOMS-s\u00fcsteemiga, mille j\u00e4rel ta kandis \u00fchte padja p\u00e4evas.\nOtsustati l\u00e4bi viia ATOMS-s\u00fcsteemi t\u00e4iendamine. <\/p>\n\n

“Kuus kuud p\u00e4rast aatomite t\u00e4iendamist hakkas patsient uriini h\u00e4sti hoidma, urineeris normaalselt, ta ei vajanud enam padjaid.\nN\u00fc\u00fcd elab ta t\u00e4isv\u00e4\u00e4rtuslikku elu, on operatsiooni tulemustega rahul,” \u00fctleb arst. <\/p>\n\n

D. Trumbeckas on rahul, et k\u00fcmne aastaga on uriinipidamatuse raviv\u00f5imalused Leedus paranenud ega j\u00e4\u00e4 l\u00e4\u00e4neriikides kasutatavatele ravimeetoditele kuidagi alla.<\/p>\n\n

\"\"<\/figure>\n","protected":false},"excerpt":{"rendered":"

Erinevates riikides on uriinipidamatus (uriinipidamatus) 10-30 protsenti.
\nPatsientidel.
\nUriinipidamatuse juhtumeid \u2013 isegi kaugelearenenud staadiumis \u2013 saab kontrolli alla saada. <\/p>\n","protected":false},"author":8,"featured_media":8857,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[37],"tags":[74,70,72,69,73,71],"class_list":["post-8822","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uudised","tag-atoms-susteem","tag-eesnaarme-eemaldamine","tag-kunstlik-sulgurlihas","tag-pidamatus","tag-poie-sulgurlihas","tag-sub-marg-side"],"yoast_head":"\nUriinipidamatus ei m\u00f6\u00f6du ka noortest: ilma ravita on aeg kadunud - Ambercell<\/title>\n<meta name=\"description\" content=\"Emaka m\u00fcoom on naiste reproduktiivs\u00fcsteemi k\u00f5ige levinum healoomuline kasvaja, mida diagnoositakse umbes 30 protsenti. 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